Assessment of Asymmetric Dimethylarginine Level in Pediatrics with Beta-thalassemia: Relation to Cardiovascular Complications

Abstract

ardiovascular complications in β thalassemia represent a major cause of morbidity and the primary cause of mortality, despite the major improvement in therapeutic interventions. Numerous multifactorial cardiac complications have been reported associated with β thalassemia with heart failure and arrhythmias are the most important life-limiting complications. In addition, right ventricular cardiomyopathy, and pulmonary hypertension also represent common complications in the cardiopulmonary spectrum of the disease. Asymmetric dimethylarginine (ADMA), an analogue of L-arginine, is an endogenous inhibitor of nitric oxide synthase enzyme which is responsible for NO formation. Nitric oxide is a potent vasodilator and is essential to vascular homeostasis. Impairment of NO production by ADMA leads to endothelial dysfunction and promotion of atherosclerosis. Therefore, ADMA has the potential to produce considerable biological effects, particularly on the cardiovascular system. The aim of our study was to highlight the role of ADMA in patients with β thalassemia and if it is implicated in the cardiovascular complications in these patients. In this study, serum level of ADMA was assayed in 60 children diagnosed by Hb electrophoresis as having β thalassemia syndromes. A control group of 20 healthy, age-matched children was also included.